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Despite the increase in understanding about the risk factors of heart diseases and their prevention, the risk of heart attack is increasing in younger age groups and in people who have high body mass index.

Heart diseases, particularly heart attack, are one of the leading causes of mortality around the world. Owing to extensive research on cardiovascular diseases, significant advances have been made to understand the nature of heart diseases, their risk factors and their prevention. Even then, one of the recent studies has discovered that younger and more obese patients are succumbing to heart attack. Many of the risk factors in these patients have been found to be preventable.  

This study was undertaken to understand the population dynamics of heart attack. It was carried out at Cleveland Clinic between 1995 and 2014 by Samir Kapadia, M.D. and his fellow investigators. The results of the study were recently presented at the American College of Cardiology's 65th Annual Scientific Session.

During the course of the study, medical records of more than 3,900 patients who were treated for ST-elevation myocardial infarction (STEMI) were analyzed. STEMI heart attack is the worst form of heart attack and results from the complete blockage of blood vessels supplying the heart by plaque.

The researchers divided the records of Cleveland Clinic's STEMI patients from 1995 to 2014 into four categories, each spanning 5 years.

Shift in the Dynamics of Risk Factors for Heart Attack

When the baseline risk factors and the health of the patients in each of the four categories were analyzed, some astonishing figures came to light. It was found that the average age at which patients develop STEMI has decreased from the age of 64 to 60. The prevalence of obesity was found to increase from 31 to 40 percent between the first five-year span and the last five-year span.

The number of patients with co-existing diabetes increased from 24 to 31 percent. The proportion of population with high blood pressure grew from 55 to 77 percent. The proportion of patients with chronic obstructive pulmonary disease rose from 5 to 12 percent.

One of the most remarkable findings was the change in smoking rate which increased from 28 to 46 percent, which demonstrated an overall decrease in the rate of smoking over the last 20 years and was the only shift that contradicted the national trends; all the other figures of the study matched the national trends. The study showed that the number of patients with multiple risk factors has also increased from 65 to 85 percent.

The Future Implications

The study has helped find the trends of cardiovascular diseases, especially heart attack. It is expected that with better understanding of their condition and risk factors, high risk patients will be able to adopt an active approach for the prevention of heart attack. This way, the patients will be able to take ownership of their own condition which means adopting a heart-healthy lifestyle. Among the preventable risk factors for heart attack are exercise, smoking and a heart-healthy diet.

According to Dr. Kapadia, prevention constitutes the core of primary care. The primary care physicians and the patient both need to own this problem in order to tackle it heads-on.

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